There’s an effort underway in Washington to strengthen military combat casualty care while bolstering national medical readiness.
The House Appropriations Committee has taken the first major step toward these goals by including $20 million dollars in legislative funding as part of the final National Defense Authorization Act (NDAA) draft making its way through Congress.
“We are deeply grateful that the committee has prioritized this investment,” Jonathan Miller, president of RESPOND‑US, told Military.com. “Their leadership makes clear that Congress understands the stakes—that medical readiness is not a luxury, but a war-fighting requirement.”
RESPOND‑US stands for Readiness and Emergency Systems Partnership for Operational National Disaster Response. Launched earlier this year, the Washington, D.C.-based nonprofit advocacy organization addresses gaps in trauma and emergency medical readiness for members of the military and civilians, with a focus on improving medical care for both combat and mass casualty events.
“This funding is an essential first step toward ensuring our nation is prepared before the next conflict begins,” Miller added. “This is a defining moment for American national security and for every service member who will one day depend on a trauma system prepared to save their life.”
Inspiration From Ukraine
The bill, as written, calls for “the establishment of a partnership program between the United States, the Indo-Pacific region and the Artic region for trauma care, disease and non-battle injury, health systems support and research.”
Essentially, it puts resources in place to modernize the military’s combat trauma care with the resources needed to better treat injured soldiers now and in the future.
“With that $20 million, we wanted to make sure there’s resourcing behind it, to modernize trauma care and other medical care,” Miller explained. “Whether it’s advances in blood products or equipment for medical evacuations, those are the kinds of resources the money would be used for.”
Last month, Ret. Col. Michael Davis, chief medical officer of RESPOND-US, published an editorial in The Hillcalling for the need to increase resourcing and create military-civilian partnerships to save lives.
“As a surgeon deployed to Afghanistan, I treated some of the most severe battlefield injuries imaginable,” Davis wrote. “I also saw what happens when systems begin to fracture—when evacuation is delayed, communication breaks down, and capacity is exceeded.
“In those moments, survival is no longer determined by skill alone. It is determined by whether the system itself is prepared.”
RESPOND‑US points to lessons learned in Ukraine, showing the modern-day demands on a war-torn nation’s medical system and how the U.S. is often called to help.
“Ukrainian forces have shown that survival rates rise dramatically when trauma care, evacuation and coordination are established before the first shots are fired,” Miller told Military.com. “Their experience has also revealed the consequences when medical infrastructure is strained, fragmented or built too late.”
Minimizing a High Fatality Rate ‘Meaningful’
Several statistics underscore the dire need for a modernized combat casualty care system for the U.S. military.
According to RESPOND-US, the projected casualty fatality rate in the first three months of a major conflict is 50%. That data is based on military medical modeling, representing approximately 50,000 deaths.
The organization reports the share of those deaths that could be prevented with modern trauma systems, coordination and readiness infrastructure is roughly 25%—the equivalent of about 28 service member lives per Congressional District.
RESPOND-US also lists just one Level I trauma center—Brooke Army Medical Center in San Antonio, TX—in the entire Department of Defense. The organization also reports that the National Institutes of Health currently spends zero dollars on trauma research. Instead, 100% of federally funded trauma care research flows through the DOD.
“Study after study has shown that preventable deaths surge when trauma systems are under resourced,” Miller said. “The committee’s decision to appropriate $20 million for combat casualty care is a meaningful acknowledgment of that reality.”
It is up to lawmakers in both the House and Senate on whether this provision is included in the final bill, which has no current timetable for completion and a vote in both chambers. The final appropriations also remain under consideration, though Miller remains optimistic.
“The goal is to have anywhere from $20 million to $50 million approved for combat casualty care,” Miller said. “We are really pushing this for the good of the community, to save lives and to have zero preventable combat casualty deaths in the near future.”
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