The right wing is hyperventillating over “Obama’s private army” in the Health Care Bill.

Fox news video HERE.

Usually Judge Napolitano can get into the details of the legal problems, but don’t get your knickers in a knot too soon, because this idea is not new. It used to be called the “US PublicHealthService Commissioned Corps”.

I once belonged to them while working with the IHS (Indian Health Service).

Fact check has some of the details.

Before the law was passed, the Public Health Service, unlike other elements of the government’s seven uniformed services, didn’t have a “ready reserve” – a cadre of individuals who could be called up involuntarily in times of need. What it had was a regular, full-time corps of 2,800 doctors, nurses, scientists and other medical professionals, which was the limit under law. It also had a reserve corps. But most of the individuals in the reserve corps, which was larger than the regular corps, were on extended active duty for the duration of their careers; in other words, they worked full-time, just like the regular corps, because they were needed, but the statutory cap prevented the service from bringing them into the regular corps.

The new law eliminates the personnel cap and brings the members of what used to be the reserve corps into the regular corps, which as a result now numbers about 6,600, according to an official at the Public Health Service who spoke to us on background.

Let me put this into English and give you a little history.

In the olden days, docs were drafted to serve in the military. Some didn’t want to go, so they were given the option of doing their two years service in the Public Health Service.(The PHS Commissioned Corps had originally been a Navy outreach to treat sailors with infectious disease, and later they were tasked to supply much needed medical care on Indian reservations.)

After the draft was eliminated, Jimmy Carter separated the Commissioned Corps from it’s military links.

But this meant that most of those who joined it were not “two year wonders” who spent two years working in these hard to staff areas, and after leaving went into private practice and never looked back.

But after the draft ended, more and more of the doctors/nurses/pharmacists who joined were ordinary folks who wanted to make a career in the position. Hence, there were few left to be called for in emergencies except for those who were still working with the government.

In contrast, there is a much larger military contingent out there to call up in emergencies or war. After your service, you are active reserve, and then “ready reserve”. The joke for us docs was that we might be “discharged” on paper, but in case of a major war, they’d find our nursing home address and put us to work if we were needed.

This, of course, was in the days when nuclear war was still a possibility.

Nowadays, the real problem is civilian disasters.

Why would the federal government need to call up doctors and nurses? Well, when I was in the USPHSCC, some of my fellow officers were called up to treat the sick among the “Mariel Boat Lift” refugees. During Katrina, my fellow doc and others at our clinic were on call to be sent there to treat casualties.

But in a real emergency, this would mean taking about one third of the medical/pharmacy/nursing staff from IHS clinics and hospitals, which are already notoriously understaffed.

Hence the need to reestablish an “on call” reserve of medical people for civilian emergencies.

Now, a lot of docs might not want to sign up to work in an isolated clinic, nor would they want to go camping out with their local National Guard or Army reserve. Yet they would be willing to take off from their practice for emergencies such as Katrina.

Voila, expand the “ready reserve”. Again, via Factcheck:

Blueprint for a Healthier America, published by a nonprofit group called the Trust for America’s Health to help guide the next administration and Congress:

Blueprint for a Healthier America: There are not sufficient numbers of public health professionals to respond during major health emergencies, and when Corps members are called away to respond to emergencies, it means their ongoing functions are often neglected. If a “Ready Reserve” program was created, retired members of the Corps could become reservists who could be deployed on short notice during emergencies, or could fill in at federal agencies when active members are needed during emergencies, to ensure ongoing functions are carried out. Reservists would be required to participate in an appropriate number of drills and training throughout the year. Members of the reserve could also help fill in to provide services for underserved communities where health problems are the greatest.

Hmm…wonder if that last part is in the Obama Health bill, because that could mean that you, as a reservist, could be drafted to fill in if they couldn’t find ordinary docs to fill their positions.

So all of this is nothing new.

Of course, as one who worked in the Federal system (both as PHSCC and Civil service), the dirty little secret is that the paper work will be so huge that by the time they call up these guys/gals, the civilian disaster folks and regular military will already be there.

However, it will allow the President to overrule a governor to send in medical help.

One of the problems blamed on Bush was failure to act in Hurricane Katrina; but the real cause was a governor blocked him from sending in aid. She was under the impression that getting together supplies and personnel from FEMA and the National Guards, a huge logistical task that then had to overcome flooded and blocked roads and long distances,  was as easy as Captain Kirk asking for a transporter to zap him down. The dirty little secret of Katrina was that the active duty Navy, Coast Guard and others were already busy rescuing folks (out of sight from the Mainstream media) but that the quickest help would require the governor’s okay, which was not forthcoming.

Now, the President can just go over the head of the clueless governors, and can just say: Help is on the way, and zap, the bureaucrats will find the papers and call the people up and arrange transport to the disaster area. All of this will take the same three to seven days that it took FEMA and the National Guard, but never mind. This time, the press will be praising the “quick response”.

So “private army”? Nah. Most of these civilian docs, unlike those in the IHS/PHS,will be Republicans, but that is another story…


Nancy Reyes is a retired physician living  in the Philippines. She blogs at Finest Kind Clinic and Fishmarket. She served in the UPSCC, and later in the National Guard.

Be Sociable, Share!