[H.A.S.C. No. 93-71] SUBCOMMITTEE NO. 4 HEARINGS ON THE FAILURE OF THE DEPARTMENT OF DEFENSE TO PROPERLY IMPLEMENT DOCTORBONUS LAW HOUSE OF REPRESENTATIVES, SUBCOMMITTEE No. 4, Washington, D.C., Wednesday, September 25, 1974. The Subcommittee met, pursuant to notice, at 10 a.m., in room 2118, Rayburn House Office Building, the Honorable Samuel S. Stratton (chairman of the subcommittee) presiding. Mr. STRATTON. The subcommittee will come to order, and Secretary Brehm, would you take the witness chair, please. Mr. Secretary, have you ever testified in this room before? TESTIMONY OF HON. WILLIAM K. BREHM, ASSISTANT SECRETARY OF DEFENSE FOR MANPOWER AND RESERVE AFFAIRS Secretary BREHм. Yes, I have, Mr. Chairman. Not before this subcommittee, however. Mr. STRATTON. If you have testified in this room before then I take it that you have noted the inscription on the podium in front of you, which is from the Constitution. It points out that Congress shall raise and support armies and provide and maintain a navy. That inscription was placed there some years ago, Mr. Secretary, at the direction of a former chairman of this committee, Mendel Rivers, because at that time under the aegis of Mr. McNamara the Department of Defense appeared to forget the fact that the Constitution provided that Congress shall be responsible for our defense policies and our defense legislation. At that time the Department of Defense tended to regard the members of this committee as a bunch of fuddy-duddies who really weren't intelligent enough to understand some of the provisions associated with the maintenance of our defense and they didn't bother to cut us in on what was happening. Chairman Rivers recognized this very early, and took a somewhat unusual step of having those words embossed in gold and placed on the front of the podium so that Mr. McNamara or any other representative of the Department of Defense might be reminded that this committee was the one, and this Congress was the one, that was responsible for the basic organization of the Defense Department, and the basic decisions associated with it, and not some bureaucrat with the Defense Department or some smart systems analyst who might feel the members of Congress were really too stupid to understand what was going on, and that any attempt to consult with the Congress was really unnecessary. (1) We haven't had occasion to invite the attention of representatives of the Defense Department to that inscription for some years after Mr. McNamara left. Apparently Mr. McNamara began to get the message that Congress shall raise and support armies and the Secretaries of Defense who followed him seemed to understand that, but the reason that this meeting has been called this morning and the reason that I am deeply concerned, as is every other member of this subcommittee, is that something has been transpiring in the Department of Defense, and our information is that you had a lot to do with it, which indicates that that old attitude is back again in the Department. Somebody over there seems to forget that Congress is the one that is responsible for maintaining our defense establishment and for directing how it shall proceed, and somebody over in the Defense Department seems to have the idea that you can write the laws yourself and interpret them without any reference to the Congress of the United States. This is a very serious matter. It was a very serious situation with Secretary McNamara. He thought he could ignore Congress, and he succeeded in doing it for some time, but sooner or later this thing catches up with those who ignore Congress and it caught up with him. We intend this morning to try to find out what is going on in the Defense Department, who is responsible for this attempt to ignore this committee, and we are going to see that it doesn't happen again. That is why you are here, and that is why these other witnesses are here. I can't think of anything that is more serious or more grave or more likely to create a serious problem in the relationship between this body and the Department of Defense than what has proceeded in the past 6, 7, 8 months, with respect to the doctors' bonus legislation. That is why we are here today. Let me remind you, Mr. Secretary, that on November 27, 1973, Secretary Clements addressed a letter to Senator Stennis of the Senate Armed Services Committee, which was a followup of some discussions on areas of critical importance to the Defense Department. The letter indicated as follows: That it was intended, and I quote, "to express the urgent priority assigned by the Department of Defense to several sections of DOD Legislative Proposal 93-3, the 'Uniformed Services Special Pay Act of 1973.' I fully recognize the heavy workload confronting both your Committee and the Congress in general, and the limited time available to address the 'Special Pay Act.' I would not trouble you at this time were it not for the high priority that I place on the three sections described below. "*** Of the various officer specialties in the health field required in the Armed Forces, medical officers are the most critical. If we are to retain and attract the required numbers and quality of physicians in an all-volunteer force, additional financial incentives must be provided. "***Since the most immediate and critical problem," this is in November of '73, "is with medical officers; and since it is only the latter group where significant pay disparities exist in comparison to average civilian economic opportunities, I believe priority action at this time can be limited to the medical officer problem." On November 29, 2 days later, the Department of Defense forwarded legislation to the Armed Services Committee. In an accompanying letter, the Acting General Counsel said this. Again I quote: "Although the military departments still have approximately 13,000 physicians on active duty as a result of the doctor draft authority. that existed for 22 years, less than 2,000 of these are true career officers. Our best career procurement source consists of the approximately 3,300 physicians who will be completing their 2 years of obligated service next summer. These young physicians generally make their civilian commitments approximately 6 months before their release from active duty. Early enactment of this proposed legislation would enable us to influence favorably many of those decisions. 66* * ** We are concerned that any further delay"-and this is in November of 1973, Mr. Secretary-"in addressing the military physician compensation problem will result in unacceptable losses of senior physicians required for the conduct of the residency training programs in our military teaching hospitals which, during the past 25 years, have been almost our sole source of career medical officers." End of quotation. On December 13 and 14, 1973, the Senate Armed Services Committee held hearings on the doctor bonus bill, and testifying for the Defense Department was none other than yourself, William K. Brehm, Assistant Secretary of Defense for Manpower and Reserve Affairs. You said in part as follows, and I quote: "These two items of urgent legislation have been carefully designed to aid in meeting essential manpower requirements in an all-volunteer environment." You also said, and I quote further: "If we are to retain and attract the required numbers and quality of physicians in an All-Volunteer Force, additional financial incentives must be provided. We do not believe it feasible or desirable to seek to match the economic alternatives available to physicians in the private sector of our economy, but we do believe it is essential to narrow the gap that now exists between the compensation of physicians in the Armed Forces and those in the private sector. ***Even with accessions from the Berry plan and other procurement sources, and reductions in Medical Crops authorizations, we expect shortages of military physicians by the end of Fiscal Year 1974" that is June of 1974-"with substantial increases in the amount of shortages projected for fiscal 1975 and fiscal 1976. * * "The need for enactment of this legislation is urgent." You said that on December 13 and 14, 1973. Do you recall that, Mr. Secretary? Secretary BREHM. I do indeed, Mr. Chairman. Mr. STRATTON. On February 25: This subcommittee, again in response to urgent pleas from the Department of Defense, and from the medical establishment of the Department of Defense, began its hearings on Senate 2770. Dr. Cowan, the Assistant Secretary of Defense for Health and Environment, was one of the witnesses. Dr. Cowan had just taken office a week before. In his statement, Dr. Cowan repeated the statement of Dr. Wilbur in December, that without the bill, there would soon not be enough physicians to provide the military medical care mission, and stated that enactment of the bill was essential to achieve an All-Volunteer Force. Well now, those are the statements that were presented to this committee, Mr. Secretary. No questions about the urgency of the matter, no question about the pinpointing of time, the end of fiscal year 1974, and you will recall that this committee enacted this legislation. It was signed into law on the 6th of May. The date was significant because all of the witnesses that we had talked to had indicated that the exodus of physicians who were no longer required by the draft would begin in June, and as I have already read in your testimony, if you were going to retain these doctors with these added incentives, you had to get that information to them early so they could make the decision before they got out, before their time ran out. So the bill was signed on the 6th of May. It was to be effective on the 1st of June and that is almost 2 months before most of these doctors were ready to get out. What happened, and you are well aware of this fact, is that in spite of what we had done in this body, it was not until the end of July, 3 months from the enactment of this legislation, that we were finally able by threats from this committee to persuade the Department of Defense to sign off on its regulations for implementing this legislation and get them over to the White House-3 months without a single word from the Department of Defense, without anybody telling us that the testimony that had been presented to us was no longer operative-I think that is the word that has become famous for this kind of action-and that somehow something else was going on in the Defense Department. We didn't get it out of your office until we threatened to bring you back from a trip, a junket that you were making down to Texas or somewhere. You wanted somebody else to come up here and testify in your behalf and we told you that if you didn't get this thing out of the Defense Department and get it over to the White House, that you had better be back here before this committee. Do you recall that, Mr. Secretary? Mr. BREHM. I know the event you are talking about, Mr. Chairman, yes. Mr. STRATTON. And this thing continued to sit in the Bureau of the Budget and in the White House until finally a personal call from me to the President of the United States and to the President's Chief of Staff resulted in its being approved. Even then it was in a somewhat amended form from the way it had passed this Congress, and in an amendment form from the way the testimony had indicated it was intended to be utilized. The regulations were signed into effect by the President on the 5th of September. That is 4 months for this urgent legislation to be signed, and then in amended form and then only after a personal plea from the chairman of this subcommittee to the President of the United States. That call prevented a proposal presented by the Office of Management and Budget from being adopted in place of the one recommended by the Department of Defense. Now what is going on in the Department of Defense and what is going on in the Government of the United States, that we were told this urgent legislation was needed back last November to prevent the serious loss of physicians we get the bill enacted in May, and it isn't until September the 5th, after some long and hard prodding, that we finally get a watered-down version of the bill implemented by the executive branch? That is why I invited your attention to those words on the podium. We still haven't received a single word of indication from you or anybody else in the Defense Department as to what is going on, why you |