The Health Care Debate
I believe you overlooked a critical fact in your February editorial on the Obama health care reform plan and its impact on defense spending [“ObamaCare Vs. Defense,” February, p. 2]. You failed to point out the consequences if we do nothing and maintain the status quo with regard to health care costs in this country. You contend that Washington is on an irresponsible course in pursuing ObamaCare, but I submit that the real irresponsible course on health care is the one that does nothing.
I agree that government estimates on any major program, whether it be health care or a defense system acquisition, are always low-ball figures. The 10-year $1 trillion estimate for health care reform is very likely no exception. However, no matter what the real number is, the skyrocketing costs of medical care in this country, if left unchecked over that same 10-year period, will make that number look like a bargain. With the rising costs of medical procedures and the way we use them, and the consequent increases in Medicare, Medicaid, and insurance premiums (and emergency room costs for those who can’t afford them), we will be confronted with an even tighter squeeze on defense spending.
I am not particularly enthralled with the way Congress is going about health care reform, what with the backroom dealings and the Nebraska exemption. Our legislative representatives, particularly the entrenched ones, always seem to be more interested in getting re-elected than in doing what’s right for the country. However, the overall objective of Oba-maCare of reining in health care costs and insurance premiums and providing basic coverage at a reasonable cost to all citizens is so important that we will have to live with a less than perfect bill.
Unless you can suggest a viable alternative to ObamaCare, your concern that the “nation is face-to-face with disarmament by entitlement” will not be alleviated by its defeat.
Lt. Col. Frank Welsh,
Thank you for an excellent editorial outlining the macro implications of excessive government debt and how ObamaCare would further imperil our ability to survive economically with the obvious implications for national defense. I have been frustrated by the positions taken by other Washington-based military organizations and their responses to my comments regarding government spending and debt. …
The implications for our children and grandchildren are not only how will they pay for the unbelievable debt load but can they continue to enjoy our way of life (and liberty), which can be preserved only with a strong, effective and superior military? The average age of the Air Force airframes, the minimal number of replacements in the pipeline, and the general malaise of the industrial base needed to take us to the next level (both in quantity and quality) is unacceptable.
Lt. Col. Adam G. Haybach,
Your editorial misses an essential point.
We already have the most expensive health “system” in the world, and it is not a very good one at that, despite the incessant propaganda. And it is getting more expensive every day. The President at least is trying to get the costs under control, however ugly the process looks.
You need to support the concept of health reform if you want to protect the defense budget.
While placing the blame for reduced future military spending on the Congress’ feeble attempt to correct our fatally flawed health care system, you fail to note that objective scientific studies tell us that 20,000 Americans die each year due to lack of access to adequate health care.
You fail to mention that high health insurance costs are destroying small business and are the leading cause of personal bankruptcies in our nation. You discount the opinion of “a large plurality of Americans,” who told Pew Research Center pollsters that we can ask our allies to take more responsibility for their own security costs. You disparage the Europeans, who have health care systems with universal access, zero personal bankruptcies due to health insurance lapses, and the wisdom to let us spend prodigious amounts of borrowed dollars for their national security. And you forgot to remind your readers that we spend more on defense (or offense, in the case of Iraq) than the next 10 nations put together, including China. We can have both health insurance reform and an adequate defense budget, but our situation is not improved by selective memory or misleading editorials.
Col. Steve Waller,
The ugly products before Congress are not “ObamaCare” but the typical offspring of the compromises made to bring competing interests together under the intense scrutiny of hospital associations, pharmaceutical companies, insurance companies, device manufacturers, and squabbling physician and allied health care “professionals” fighting for their chunk of the golden egg being laid. The industry which sells drugs, surgical procedures, hospital bed space, laboratory testing, medical equipment, “insurance,” and occasional health care is hugely inefficient, vastly overpriced, and focused on treatment rather than prevention and procedures rather than on management. We have the most expensive medical care in the world with Third-World immunization rates, and Third-World maternal and infant death rates, while a privileged few are being paid or taking millions of dollars for services which would have never been shown to improve health or longevity. The costs of delivering medical services vary by 100 percent from one area of the country to another, with no correlation to the cost of living or other costs in the same areas. Delivery of medical care for most Americans is rationed on the basis of ability to pay rather than on need or the potential for benefit. Our obsession with keeping medical care as a negotiated employee benefit rather than a national responsibility has benefited only those who profiteer from the inflated costs.
Second, our national fiscal crisis cannot be blamed on health care proposals which haven’t been enacted. We are having a national debate about the cost of doing business for the first time in almost 10 years. The previous Administration and complacent Congress provided huge tax breaks to the very rich, while waging war and hiding the fiscal effects of the tax cuts (and the costs of protecting our nation) in budgetary tricks and sideshow prescription drug benefits which reaped huge benefits for the pharmaceutical manufacturers that had successfully prevented any attempts at price controls.
The fundamental problem is not so-called social entitlements but a total lack of resolve to face the true cost of governing.
Dr. (Col.) A. Bradley Eisenbrey,
Grosse Pointe Woods, Mich.
I saw a blatantly political piece that used a completely unfounded hypothetical argument: that is, health care legislation represents an assault on defense spending. In my opinion, this is equivalent to saying my home mortgage is an assault on my grocery bill— I can’t ignore one necessity simply because I believe the other necessity is more important (or more expensive).
My company pays a significant amount in health care expenses every year (we are a self-insured company), and I pay a significant amount every year myself through premiums and co-pays. To me, reforming our health care system is both a moral responsibility and an economic necessity (especially for American businesses). When military-related publications like Air Force Magazine promote opinions about health care legislation, I think it wise to remember that a significant portion of their readers (active duty and retirees) benefit from a government-funded, reasonably good, reasonably efficient, and reasonably expensive universal health care system through Tricare.
Brian D. Smith
To begin with, the national debt is an accumulation of budget deficits, not simply entitlement programs. US debt ballooned 50 percent between 2000 to 2007, growing from $6 trillion to $9 trillion because, year after year, the government cut taxes, 52.5 percent of which went to the wealthiest five percent of taxpayers, and increased spending, including unpaid-for wars. The $700 billion bailout helped the debt grow to $10.5 trillion by December 2008. The debt is now 83 percent of GDP, up from 51 percent in 1988 (source: US Treasury, “Debt to the Penny,” Bureau of Economic Analysis). With regard to the impact of Social Security on the debt, the fact is that the Social Security Trust Fund took in more revenue through payroll taxes leveraged on baby boomers than it needed. However, instead of investing or at least protecting Social Security taxes, the Social Security Trust Fund financed increased current government spending, creating a future Social Security liability. Nonetheless, at about $18 trillion, that future Social Security liability is about the same as the Bush Administration unfunded Medicare prescription drug benefit enacted in 2006, which is part of an $89 trillion Medicare liability.
But the problem isn’t just Medicare, Medicaid, or government health care spending. The problem is all US health care spending as a national economic competitive issue. To summarize the facts as published by the Congressional Research in 2007, the United States spends more private and government money on health care and gets less for it than any of the 30 democracies in the Organization for Economic Cooperation and Development (OECD), the most economically advanced countries in the world:
In 2004, at the end of President Bush’s first term and after a decade of Republican control of Congress, 15.3 percent of the US economy was devoted to health care, compared with 8.9 percent in the average OECD country and 11.6 percent in second-place Switzerland.
The US per capita on health care in 2004 was $6,102— more than double the OECD average and 19.9 percent more than Luxembourg, the second-highest per capita country.
Among OECD countries in 2004, the United States had shorter-than-average life expectancy and higher-than-average mortality rates.
Even putting aside the issue of the uninsured, the U.S. population did not and does have better access to health care than OECD countries.
Although the United States has shorter wait times for nonemergency surgeries compared to some OECD countries, Americans found it more difficult to make same-day doctor’s appointments when sick and had the most difficulty getting care on nights and weekends. Americans are most likely to delay or forgo treatment because of cost.
The central goal of health care reform is to reduce the projected rising government and private cost of health care while increasing quality and access. Notwithstanding the discredited views of Martin Feldstein referred to by Editor in Chief Robert S. Dudney, the CBO, the legitimate arbiter of the cost of health care proposals, has concluded that either the House or Senate health care bill will do this and significantly reduce projected federal deficit.
Victor D. Bras
As Gen. “Chappie” James used to say, “Either you’re part of the solution, or you’re part of the problem.” Frankly, you’re part of the problem.
To honor the magazine’s request to keep Letters to the Editor brief, I won’t engage you on the full extent of your faulty logic; I haven’t seen such a target-rich environment in quite awhile, though. To be objective, you do have a couple of valid points: 1) The US economy does underwrite our defense capabilities; 2) The “deficit-spending joy ride must end.” The Obama Administration has a comprehensive plan to strengthen the economy, including ending the deficit-spending joy ride we experienced in the last decade. And key to strengthening the economy is fixing health care, instead of letting it continue to hamper our growth.
Who cut taxes while increasing spending during the 2001-08 period What were they thinking? Evidently, they had the same shortsighted view you do—that we can invest more in defense while ignoring the rest of the nation’s needs. That’s a sure path to America’s decline.
Col. James E. Allgood,
According to the CBO as recently as Dec. 19, 2009, the current health care reform bills will reduce, not increase, the deficit by over $100 billion through 2019 (http://cboblog.cbo.gov/?p=447). But, even more troubling, a new study published in the December 2009 issue of the American Journal of Public Health puts the number of deaths among Americans between the ages of 18 and 64 associated with lack of health insurance at 44,789 a year. This is more than the Marine and Army combat deaths for the entire Vietnam War. These realities demonstrate how you do a profound disservice to those trying to address the health care cost crisis and denial of care for millions of our citizens by indulging in heartless partisan hyperbole.
Lt. Col. Tony Wolusky,
Colorado Springs, Colo.
The editorial regrettably fuels an increasingly polarized and obstructionist national climate on this issue. It is ironic that military members, arguably benefitting from the one of the greatest government-provided health care systems, could lobby to deny the reform needed for all Americans to gain greater availability and control of costs for such a fundamental need. Moreover, if we do not face the broken system this country has on health care access and cost, then that will be a national security issue of much greater importance to us and our children than acquisition of another F-22.
Col. John S. Chilstrom,
The article, “A Small War in Panama” in your December 2009 issue, brought back many memories. Mr. John Correll did a great job summarizing Operation Just Cause. Having flown in the lead aircraft of two F-117s that employed weapons during Operation Just Cause, I would like to comment on a couple of his observations regarding the stealth fighter’s participation.
The stealth fighter was not chosen for the mission because of its stealth characteristics. In fact, the pilots who flew the mission never configured their aircraft in “stealth mode.” The stealth fighter was chosen, over other aircraft, because we proved to Lt. Gen. Carl Stiner and his war planners that we could hit a designated target at a precise time-over-target (TOT). This demonstration was extremely important for two reasons.
First, there were civilian buildings in the proximity of the barracks at Rio Hato, and they did not want any collateral damage.
Second, we had to deliver the bombs at the exact TOT since the Army Rangers and Marine/Navy SEALs would be jumping into the same location one minute after our second bomb exploded. The aircraft could not be late dropping their bombs!
Originally, two of our targets were the Panama Defense Force (PDF) barracks at Rio Hato. Less than 24 hours before launch, we were told that our mission was no longer to hit the barracks but to drop our bombs in fields short of the barracks in order to “stun and disorient” the PDF. When we arrived at our briefing several hours before takeoff, I was given a photo of a field that was in front of my original target, the PDF barracks.
There was triangle marked over a bush in the center of the field and I was told this was my new target. I immediately asked my commander how I was expected to hit a particular bush in an open field. He told me he didn’t care where the bomb landed in the field, just make sure my bomb did not hit within 50 meters of the barracks. He relayed the same information to my wingman. (We were never told that General Powell increased the distance to 200 and 250 yards!)
I would also like to comment on the issue regarding the swapping of targets. At Tonopah, we spent almost one hour in our aircraft at the end of the runway, waiting for our takeoff time. At one point during this period, my wingman called me on our secure radio and said he was concerned that the forecasted winds might blow the smoke from my bomb impact over to his target area, possibly obscuring his target. Since our two targets were a significant distance apart and since he would be dropping his bomb one minute after mine, I did not agree. I also was concerned since I did not have a photo or coordinates of his target and he did not have a copy of mine. I relayed to No. 2 that for now, we would keep our briefed targets, but I would check the actual winds during my target run.
Since a plan rarely goes as briefed, when I got to my target run, I noticed there was a cloud deck obscuring my target (weather had been briefed to be clear with no clouds), so I had to descend below 4,000 feet to get below the cloud deck in order to use the targeting system. This is another area where Mr. Correll’s article is not entirely correct. The F-117’s equipment did not begin “acting up” while clouds and humidity “played tricks” on the targeting system. As anyone who has ever flown with an infrared targeting system can attest, flying at low altitude in high humidity, like Panama, greatly decreases the range at which targets can be identified. Additionally, the winds during my target run were negligible, so I decided not to switch targets. Therefore, I employed my weapon on my original target, as briefed, and did not “erroneously” bomb my original target. My weapon hit exactly where I aimed, approximately 60 meters from the PDF barracks. Now entered the fog and friction of war! My wingman saw the explosion in his targeting display and mistakenly thinking we had switched targets, keyed his attack off my bomb. This resulted in his bomb hitting 300 yards from his original target. But I must stress, his weapon hit exactly where he aimed at his precise TOT. I take complete responsibility for not being clear regards to which targets we were to hit, but in the end, we accomplished our objective to “stun and disorient” the PDF.
Finally, I would like to make it clear that the F-117 participation was never meant to be made public. However, since the mission became public and there has been some confusion about the role the stealth aircraft played, I just wanted to set the record straight in a few areas. The F-117 stealth fighter performed flawlessly. Although the bomb craters were not both 50 meters from the PDF barracks, the weapons were released and hit exactly where they were aimed.
As Mr. Correll states, “Questions about the F-117 itself were answered conclusively in the Gulf War two years later, where the Nighthawk achieved spectacular accuracy in precision attack.”
Maj. Gen. Gregory Feest
Randolph AFB, Tex.
The debate over the 2018 bomber, as discussed in the January editorial [“The Obama Bomber,” p. 2], is often cast as a choice between the merits of a manned bomber or unmanned vehicle system. However, this dichotomy may leave out an intriguing third option of a blended crew complement including virtual crew members. In the interest of full disclosure, I’m an unabashed proponent of manned aircraft, but it would be shortsighted to ignore the virtues of unmanned aircraft and the technology that supports them. I flew the B-1 operationally and the B-2 as a test pilot during the development program. While the B-2 could be easily flown by two pilots during most mission phases, the workload increases dramatically in a dynamic situation calling for defensive action, route changes, and flexible targeting. Add system malfunctions or emergency procedures and the workload could become unmanageable, especially when fatigue begins to creep in mid-way through a 40-hour mission. A blended crew concept with virtual crew members could take advantage of the best features of manned aircraft and unmanned systems. With the same data link systems which allow Predator and Global Hawk pilots to manage missions from half a world away, the future bomber could include the communications and systems interfaces to allow other crew members to actively participate in the mission without actually being on board. A virtual crew member would be fresh and well-rested as the aircraft enters the combat zone. Since a virtual crew member is not limited to physical presence in the aircraft, he could fly several sorties during a single raid, taking advantage of the tactical insight (target locations and defensive situation) gained from a previous run through the target zone. During the return trip, the virtual crew member could also improve safety by providing an extra set of eyes while one pilot rests to combat the inevitable fatigue.
A blended crew provides the best of both worlds while eliminating many of the costly elements of either manned or unmanned systems. Virtual crewmembers allow the manned portion of the crew to remain small, reducing cockpit size and accommodations and crew training costs. The manned portion of the crew means that many parts of the control system architecture required of an unmanned system (i.e., flight controls) can be eliminated while retaining the benefit of the unmanned portion of the sensor, mission management, and weapons systems. System development and flight test can also be completed faster and more safely with the manned vs. unmanned system. Perhaps most importantly, retaining the manned part of the crew also maintains the critical human element necessary for unjammable, on-scene situational awareness and decision making and weapons control for nuclear surety. Industry competitors and those responsible for requirements generation would be wise to consider a blended crew for the Next Generation Bomber.
Col. Scott A. Neumann,
The replacement USAF bomber which we may see in about 25 years (if ever) is often mentioned as being “nuclear capable” or maybe not. Anything is nuclear capable. A C-130 could carry two or three “Little Boy”-size bombs on dollies. Just roll them out the back end. In 1957, I flew a single-engine F-84F on A-bomb training flights. We had LABS (low-altitude bombing system) equipment onboard. The pilot set the gyro settings in the gun bay prior to each flight. Classifying an aircraft as being nuclear capable or not nuclear capable really has no meaning.
Lt. Col. Tom Garcia,
Las Cruces, N.M.
John Tirpak provides a cogent outline of the Air Force’s fighter force structure dilemma in the February 2010 issue [“Rising Risk in the Fighter Force,” p. 24]. Given a cap of 186 F-22s, shifting F-35 delivery rates, and a mitigation strategy that struggles to sustain Reagan-era legacy fleets, he identifies that “the first order of business is to determine how much life is left in the old airplanes,” and that, “to that end, USAF is conducting what are called fleet viability boards.” On this point, I would like to elaborate.
The Fleet Viability Board was formed in 2003 at the direction of Air Force Secretary James Roche. The FVB’s charter is to perform independent technical assessments of legacy weapon systems and provide decision-quality recommendations to the Secretary and Chief of Staff for fleet modernization and recapitalization. The board’s independence is important to filter political bias and get straight at the science of the problem of modernizing and sustaining these platforms. An important by-product is the board’s contribution to improving the quality of Air Force aviation safety by identifying safety/sustainment issues. In fact, demand for FVB insight resulted in last year’s expansion of the organization, increasing assessment throughput nearly threefold.
Which fleets get prioritized for FVB assessment is a corporate decision process. Typically, those capability areas facing major recap decisions, but for which the Air Force needs credible facts about the legacy fleet’s remaining life and relevance, become the leading candidates. Catastrophic events, as happened with the 2007 F-15 longeron mishap, can also push fleets to the top of the order.
Each FVB assessment is an objective dive into the weapon system’s viability, providing integrated technical analysis and actionable recommendations, which inform senior leaders deliberating the POM (program objective memorandum). Board members integrate operational health, cost of ownership, and availability across various funding options and project viability for 25 years. Its roll-up benchmark, “annual cost per available aircraft,” presents a telling comparative metric. Though structural life tends to be first among equals, the board assesses the operational health of all aircraft subsystems, including propulsion, electromechanical, avionics, and offensive/defensive systems against current and future requirements. With numerous weapons systems complete, we can draw some general conclusions about the problem of sustaining legacy fleets. One ironic conclusion in particular that underpins this issue of aging aircraft is that it’s not about “age.”
The board has observed that historical cost and maintenance data do not support conventional wisdom that age alone—purely the number of birthdays—drives recap justification. Technologic complexity makes new weapon system acquisition and sustainment costs typically worse than modernizing and sustaining legacy fleets, even when those fleets require significant structural life extensions or capability upgrades. In this resource-constrained era, capability requirements offer stronger recap arguments than economics. Legacy fighters, from the P-51 to the F-15, could be kept airworthy regardless of age, but they’ve become progressively less relevant against advancing threats and technology. Therefore, recapitalization decisions should be based on when legacy fleets will be no longer cost effective compared to the alternative—cost per available aircraft—OR, it is no longer relevant against new requirements. So, while legacy fleets usually can be made viable, more important is at what cost (per available aircraft) and whether they can be made relevant for handling future challenges.
Lt. Col. Don Russell
A Hero’s Hero
I just wanted to drop you a line and let you know that my wife and I greatly enjoyed the article on her uncle, Duane Hackney [“A Habit of Heroism,” January, p. 63]. I’ve read his story before, but this was the best. Thanks again.
Larry and Roxanne Clapp
Wesley Chapel, Fla.
Re: Richard Whitcomb’s Wasp-waist Delta Dagger: To be concise, the aircraft FC-787 (“top left”) is not “the experimental YF-102,” but an experimental YF-102A [“Richard Whitcomb’s Triple Play,” February, p. 68].
Joseph R. Bowen
EW and Austerity
[I] enjoyed your January article on “Electronic Warfare Meets Austerity” [p. 42]. In the Obama era of robbing Peter to pay Paul defense budget skimming, a “modest enhancement” approach to address the current and future EW platform deficiency could be the B-1B. Since 25+ “Bones” sit in storage, why not have a low-rate production mod schedule for an EB-1B profile? The B-1B has the range to address the escort jamming mission, the fuel capacity for sustained standoff jamming, and a large airframe with three bomb bays for all the room you need for black boxes, clip-in pods, or an offensive anti-radar capability (AGM-88s). Dash speed and four G maneuverability doesn’t hurt, either. Essentially all components are off-the-shelf, and the training overhead is a minimum financial exposure with existing schoolhouses and basing. Also, as the future B-1B mission is phased out, the EB-1B mission is phased in with existing airframes. What say you, boys and girls
Keith A. Thomas
Another Option on the KC-X Tanker
[I write in regard to the article in “Air Force World: KC-X Requirements Called Sound,” February, p. 10.] With money being so tight these days it would be wise for the USAF to relook at how it is spent in such a way that our future is secure.
For instance, take the tanker debate. Air refueling was in its heyday when SAC was the big guy on the block with its 1,000 bombers protecting us day and night throughout the Cold War. The very defined Cold War is over, thanks to the USAF and SAC. We need to move on.
Today’s war is different! We are now faced with irregular warfare where unmanned aircraft systems are the new big guy on the block. That’s where the money should go.
So, why not convert the 100-plus DC-10/MD-11 aircraft in the Mojave “Boneyard” fleet into KC-10s and meld them into the existing USAF KC-10 [fleet]? Then outsource the refueling to private companies such as Omega Air Refueling. Omega has been refueling USN/USMC aircraft for about seven years using the 50-year-old Boeing 707 (KC-135).
The savings would be enormous in retirement costs alone, that are still being paid out to tanker pilots who retired as far back as 1972. We should look closely as to how we cover our six in light of our new mission!
UAV Safety Records
Your February issue had an article touting UAVs as “the” indispensable weapon” [“The Indispensable Weapon,” February, p. 32] preceding one worrying over the attrition rate of fighter aircraft in the last decade [“The Aircraft Losses Mount,” February, p. 56]. Curiously, over the same time period, the mishap rate of unpiloted aircraft was 10 times higher than the next highest manned platform (the F-16). That statistic is especially significant considering that UAVs perform far fewer takeoffs and landings per flight hour due to their endurance and begs the question whether any other aircraft with that safety record would still be flying.
The official line in seemingly every Air Force publication is that unmanned vehicles are the future of military aviation, but few have challenged that assumption based on true costs, liabilities, and capabilities. Factoring in attrition rates, satellite links, and ground control stations, what does a Predator really cost? Furthermore, since GPS and satellite links are relatively easily jammed, what liabilities are we accepting by shifting a large percentage of our inventory to remotely operated vehicles? UAVs certainly have their place as high-endurance ISR platforms complementing manned aircraft such as the MC-12, but when troops are in contact with enemy forces, the inherent latency of satellite-linked robotics makes them much less responsive to the ground component commander than manned aircraft.
Computers are better at calculations, but human beings are better at decision-making, and it turns out that’s the biggest component not only of aviation in general, but warfighting in particular. Airmen bring a lot to the fight (wider field of view, ability to hear LOS and communicate with other piloted aircraft, etc.). No matter how technologically advanced we become, MIRC chat is no substitute for voice, and robots are no substitute for a warrior with the big picture.
Lt. Col. Craig Ziemba,
Fighting With Light
Good article [“Fighting With Light,” February, p. 64]. I first studied lasers with my Stanford professor, Arthur Schawlow, who was one of the inventors. That was in the early 1960s. Then I saw a laser hologram in the late 1960s at the Hughes Malibu Lab (where the first operational laser was demonstrated). In the 1970s, I worked on the Airborne Laser Lab (Hughes did the pointing and tracking, TRW the big laser). It is now 2010. There are no operational laser weapons, but we have had laser pointing devices for a long time. It’s been 50 years, but I still believe in lasers. At some point, it will reach a practical payoff, and it will be revolutionary. It took awhile to perfect that steam engine, too.